Early this year, we shared encouraging results from the first cohort of our newborn mentorship programme in Kakamega County (in Kenya’s Western Province) where nurses and clinical officers showed meaningful improvements in newborn care skills and confidence. That pilot demonstrated that structured, hands-on mentorship could help providers apply essential practices more consistently in real clinical settings.
As we moved into the second cohort, the questions shifted.
Instead of focusing on whether mentorship could work, we wanted to understand whether improvements could be maintained, whether they could be scaled to more facilities, and whether mentorship could become part of routine practice rather than a standalone effort.
Dr. Allan Ngovoga – Program Manager Division of Newborn, Child, Adolescents and Maternal Health -MOH inspecting the Malava Subcounty Hospital, Newborn Unit, alongside Sylvia Okila- Nursing officer in charge Malava Newborn Unit and Patricia Nafula- Nursing Service Manager-Malava Subcounty Hospital. Photo Credits: Eugene Namusende
Moving from Pilot to Broader Implementation
With support from Kakamega County and the Ministry of Health, the second phase expanded the programme to six facilities, trained 18 In-Facility Mentors (IFMs), and strengthened the structure of mentorship sessions and assessment tools. This phase placed greater emphasis on facility ownership, routine mentorship practice, and use of performance data to guide coaching.
The aim was to see whether a mentorship approach proven in the initial pilot could be effectively extended and embedded within a wider set of contexts.
Continued Improvements in Provider Skills
The second cohort continued to show progress in clinical knowledge and practice:
- Neonatal resuscitation scores improved from 67.5% to 99.1%
- Newborn knowledge scores increased from 65.6% to 89.4%
Figure 1. Overall pass rate in neonatal resuscitation skills and knowledge assessment in intervention facilities.
These results indicate that providers were not only able to build skills through mentorship, but also sustain and strengthen them as mentorship became more regular and integrated into facility routines. Improvements were especially notable in key steps within the “golden minute,” CPR ratio, and feeding regimen — areas where repeated practice makes a difference.
Positive Shifts in Facility-Level Outcomes
The second phase also documented meaningful changes in newborn outcomes and referral patterns across participating facilities:
- Neonatal deaths decreased from 106 to 72
- Referrals out of facilities reduced from 73 to 53
- Referrals into facilities increased from 31 to 34
Figure 2. Summary of neonatal deaths and referral patterns in intervention facilities between 2024 and 2025.
These trends suggest that facilities became better equipped to manage and stabilise newborns, and that recognition and referral from lower-level facilities may have improved.
While these data do not on their own explain causation, they align with the observed improvement in provider competence and facility readiness. Together, they point to a gradual strengthening of the system surrounding newborn care in the participating facilities.
What Evolved in the Approach?
While the core mentorship approach remained consistent between the first and second cohorts, this phase marked an important shift in scale and engagement. The programme expanded from three to six facilities, bringing mentorship to a broader set of contexts and provider teams across Kakamega.
County leadership also became more involved, with stronger coordination and clinical oversight, including technical support from the County Paediatrician, Dr. Malangachi, which helped reinforce mentorship as part of routine service delivery rather than a standalone project.
Importantly, delivering the programme at this expanded scale provided the evidence and practical insights needed to inform the Ministry of Health’s newborn mentorship curriculum. The Kakamega experience played a direct role in shaping the structure, tools, and implementation approach of the emerging national package, and positioned the county as an early example of how facility-based mentorship can be integrated into wider systems.
Implications for national scale-up
The lessons from Kakamega’s second cohort have informed the Ministry of Health’s development of a national newborn mentorship curriculum. Jacaranda supported the first implementation of this curriculum in Mombasa in late 2025, creating an opportunity to test training materials and mentorship structures with a broader group of providers.
The programme is now scheduled to expand to Kisumu, Kisii, Nakuru, and Makueni in 2026, offering a chance to apply what has worked in Kakamega at a larger scale while strengthening areas that require further refinement.
Looking Ahead
As mentorship expands, key priorities will include:
- Reinforcing areas where knowledge gaps persist
- Continuing to support IFMs to lead mentorship independently
- Using routine data not only for evaluation but as a practical tool for guiding clinical practice
- Ensuring counties have the structures and support needed for long-term sustainability
Kakamega’s second cohort demonstrates how steady, structured mentorship — paired with facility leadership and data-guided coaching — can support improvements in newborn care practices and outcomes. While there is still work ahead, these experiences provide a practical foundation for strengthening newborn care in other counties and at national level.